| NPI | 1043825367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA16956) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 8083) |
| Enumeration Date | 2020-09-14 |
| Last Update Date | 2023-06-28 |